If you do not presently live in one of the counties of the Western
Reserve, in which county were you born?
Collaborator (if any)
If May Show entries are not accepted or are not sold:
^C^rtist will pick up at Museum.
□ Museum should dispose of.
□ Museum should ship to artist at artist's expense:
Street
City State Zip
Special Instructions
Entry Blank must be completed in full and signed; forms received unsigned will not
be accepted.
When necessary, include instructions or a drawing for assembling and displaying
an object.
Note carefully the dates for both delivery and return of objects. It is understood
that the Museum shall dispose for its own account any objects not picked up by
the dates given herein. It is also understood that accepted objects will remain on
exhibition until August 6, 1989.
Detach entire portion along dotted line and submit with slides , but retain tags
Entry Blanks
A
□ Paintings □ Graphics
□ Sculpture ^i^Crafts
□ Photography
(specify category)
Materials used (media):
fi A—
Title
iLLAb l/t 4.
‘ooo
Insurance Value
if NFS Only
s ijSA / 1 '/2_xJ *
height x width x depth
GRAPHICS AND PHOTOGRAPHY ONLY
Additional No.
For Sale
Total No. in
Edition
Price of Print
Unframed
Price of
Frame Only
ACCEPTED
DO NOT WRITE IN THIS SECTION
An* - 1(*
ACCEPTED
/
NOT ACCEPTED
/ ns
> A - ^
NOT ACCEPTED
D O Paintings □ Graphics □ Photography
U □ Sculpture '^Crafts (specify category)
Materials used (media):
Title
Price or NFS
Insurance Value
If NFS Only
Size
height x width x depth
GRAPHICS AND PHOTOGRAPHY ONLY
Additional No.
Total No. in
Price of Print
Price of
For Sale
Edition
Unframed
Frame Only
ACCEPTED
REC'D
*
NOT ACCEPTED
DATE
ACCEPTED
NOT ACCEPTED
DO NOT WRITE
IN THIS SECTION
- ( 7
/ ^4/ - 44-4